Rau F D, Manoli A, Morawa L G
Clin Orthop Relat Res. 1982 Mar(163):137-40.
Twenty-nine patients with intracapsular fractures of the femur were treated with a sliding compression screw. The overall incidence of unsatisfactory results was 48%. In the combined group of Garden III-type and Garden IV-type fractures, 58% had unsatisfactory results. The Garden IV type fractures, considered separately, had 89% unacceptable results. The most significant factors associated with an unsatisfactory result were: (1) poor reduction; (2) poor alignment or depth of the screw; and (3) the use of the long threaded lag screw. Inability to control the proximal fragment during the procedure made it difficult to maintain satisfactory reduction and may have contributed to avascular necrosis in seven of the 29 hips. Displaced fractures of the femoral neck are difficult to reduce and transfix. The sliding compression screw did not compensate for a technically poor reduction or unsatisfactory surgical placement of the device.
29例股骨囊内骨折患者接受了滑动加压螺钉治疗。结果不满意的总体发生率为48%。在Garden III型和Garden IV型骨折的联合组中，58%的结果不满意。单独考虑的Garden IV型骨折，有89%的结果不可接受。与结果不满意相关的最显著因素为：（1）复位不佳；（2）螺钉的对线或深度不佳；（3）使用长螺纹拉力螺钉。手术过程中无法控制近端骨折块使得维持满意的复位变得困难，并且可能是导致29例髋关节中有7例发生缺血性坏死的原因。股骨颈移位骨折难以复位和固定。滑动加压螺钉无法弥补技术上不佳的复位或该装置不满意的手术置入。
